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The Use of Pain Neuroscience Education in Physical Therapy for People with Chronic Pain

The Use of Pain Neuroscience Education in Physical Therapy for People with Chronic PainChronic pain affects approximately 3 million people in the U.S. each year. According to Chelsea Chrisp, PT, LAT, ATC, DPT, Director of STAR Physical Therapy in South Nashville, chronic pain is defined as pain
that persists greater than 12 weeks after an injury or onset of symptoms.

Pain may be felt in the joint that was injured or globally through the body depending on the time since initial onset or injury. Chronic pain may be referred to by multiple different diagnoses, including chronic fatigue syndrome, fibromyalgia, and even phantom limb pain following an amputation. Chronic pain begins usually from unresolved pain in a specific area that manifests into global symptoms throughout the body due to a number of outside influences. Physical therapy is a safe approach to address this pain from the source. Treatment can vary in intensity and approach depending on each patient’s needs.

Pain Neuroscience Education and PT
Physical therapy (PT) for patients with chronic pain may include pain neuroscience education (PNE) as part of the treatment approach. This component of treatment includes helping a patient understand their pain from the moment the initial injury occurred or initial onset of pain. Pain neuroscience education addresses stressors in the patient’s life that may be contributing to or enhancing lingering pain. These stressors may include physical stress, temperature, movement, immunity, and blood flow. The factors just mentioned can significantly increase the sensitivity of nerve sensors in the body that cause a patient’s nervous system to process the sensation as pain.

For example, a patient may be stressed about something going on at work or home and that can directly influence how their body processes pain, most likely intensifying the symptoms. Or have you ever heard someone say, “It is going be cold tomorrow. I know because my knee hurts?” This could be a result of the temperature receptors acting in response to chronic pain and making temperature changes process in the body as pain. PNE helps to establish possible causes of where a patient’s increased pain is coming from, which in turn allows the physical therapist to tailor their program to maximally treat the patient’s pain. The goal of pain neuroscience education is to help a patient re-train their nervous system to process pain appropriately and return to the prior level of activity that the patient is missing.

What to Expect in PT
On a patient’s first visit to physical therapy, an initial evaluation will be performed to determine where pain originated, where it is currently located, and what limitations the patient presents with. These deficits may include range of motion, strength, and functional limitations, including activities of daily living, lifting, or work demands. Pain neuroscience education can then be incorporated into a treatment program to help a patient better understand their pain and why the pain has turned into a chronic condition.
PNE will be used in conjunction with gentle repetitive motion to help reduce chronic pain symptoms. Once pain is understood, the physical therapist will teach the patient proper mechanics to recover deficits and limitations that were found in the initial evaluation and improve the patient’s quality of life. Patients will have a program that is individualized to them as every patient’s situation is different.

References:
Therapeutic Neuroscience Education: Teaching People About Pain. Louw, et al.
Why You Hurt: Therapeutic Neuroscience Education System.
Louw, et al.

Chelsea Chrisp, PT, LAT, ATC, DPT,
Director of STAR Physical Therapy in South Nashville Chelsea graduated from MTSU with her Bachelor of Science in Athletic Training. She then continued to UT Health Science Center to earn her Doctorate of Physical Therapy degree. Chelsea is currently pursuing credentialing in McKenzie Mechanical Diagnosis and Therapy, the most recognized form of manual therapy. When she’s not in the clinic, Chelsea enjoys tennis, running, and spending time with her husband and daughter.

​STAR
5505 Edmondson Pike, Ste​. ​103
Nashville, TN 37211
615​.​831​.​1710

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